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Monitoring the Effectiveness of the Vacuum Bell During Pectus Excavatum Treatment: Technical Innovation

Sergio B. Sesia, Frank Martin Haecker

University Children’s Hospital of Basel, Department of Paediatric Surgery, Basel, Switzerland

 

The vacuum bell (VB) is the only non-invasive treatment for PE, and represents a valid alternative to surgery. So far, no suitable tool was available for assessing objectively the efficiency of the VB. In collaboration with the Institute for Medical and Analytical Technologies of the University of Applied Sciences and Arts of Northwestern Switzerland, we developed a new measurement system, providing the pressure inside the VB and the related elevation of the sternum during the application of the VB. The system is mounted on the conventional VB, and is available for the different sizes of the VB. 67 patients were included in the study. A correlation between the patient’s age and the pressure related to the sternal elevation has been proven. As younger the patient, as lower is the pressure to lift the sternum to 1 cm. For the first time, we are enabled to gather pressure related elevation information in a clinical scenario. The relationship between the patient’s age, the depth of the pectus, the sternal elevation, and the pressure inside the VB, give an idea of the flexibility of the chest. With this information, we expect to: predict the duration of treatment, which is supposed to be function of the age of the patient and its deformity (form, length and deepest point of the PE) and set up a therapeutical algorithm. In case of an elastic/flexible chest (low pressure): VB as first therapeutical approach and in case of a stiff chest (high pressure): VB to soften the chest wall in preparation of the surgery.

Keywords: Vacuum Bell, Pectus Excavatum, Chest Flexibility